tbuckley/cabot-search huggingface dataset:
POS0696 DOES PREDNISONE USE DURING PREGNANCY IN WOMEN WITH RHEUMATOID ARTHRITIS INDUCE INSULIN RESISTANCE IN THE OFFSPRING?
Authors: F. D. O. De Steewninkel, R. Dolhain, J. Hazes, A. C. Hokken-Koelega
Journal: Annals of the Rheumatic Diseases (2022)

Background The use of long-term corticosteroids during pregnancy has been growing over the past decades 1 . Corticosteroids can be given when an auto-inflammatory disease like rheumatoid arthritis (RA) is too active. Several studies have shown that long-term corticosteroids use in pregnancy is associated with maternal and fetal adverse outcomes, like preeclampsia, shorter gestational age, lower birth weight and rapid catch-up growth 1-3 . These last two outcomes could influence the insulin resistance later in life 4 . Objectives Does prednisone use in pregnant women with RA induces insulin resistance in the offspring? Methods 103 children were included after their mother had participated in a prospective cohort study on RA and pregnancy. 42 children were in utero exposed to prednisone and 61 were non-exposed. To assess insulin resistance, we measured Homeostasis Model of Assessment Insulin Resistance (HOMA-IR), serum adiponectin and lipid levels, corrected for body fat distribution. Results There was no difference in mean HOMA-IR (SD) between the children who were prednisone-exposed in utero (1.10 (0.84)) and those non-exposed (1.09 (0.49)). No difference was found in mean adiponectin (SD) level, 16.45 (4.06) µg/mL and 15.40 (3.59) µg/mL, respectively. Also no difference was found in body fat distribution or lipids such as total cholesterol, fasting triglyceride or high-density lipoprotein. Conclusion Children who are prednisone-exposed in utero have no increased risk for insulin resistance at the age of approximately 7-years. This findings are reassuring, but further research has to be performed to evaluate if prednisone-exposure in utero has no other negative effects on the long-term and if insulin resistance remains absent in the future. References [1]Cai E, Czuzoj-Shulman N, Abenhaim HA. Maternal and fetal outcomes in pregnancies with long-term corticosteroid use. J Matern Fetal Neonatal Med. 2021;34(11):1797-1804. [2]de Man YA, Hazes JM, van der Heide H, et al. Association of higher rheumatoid arthritis disease activity during pregnancy with lower birth weight: results of a national prospective study. Arthritis Rheum. 2009;60(11):3196-3206. [3]de Steenwinkel FD, Hokken-Koelega AC, de Ridder MA, Hazes JM, Dolhain RJ. Rheumatoid arthritis during pregnancy and postnatal catch-up growth in the offspring. Arthritis Rheumatol. 2014;66(7):1705-1711. [4]Kerkhof GF, Willemsen RH, Leunissen RW, Breukhoven PE, Hokken-Koelega AC. Health profile of young adults born preterm: negative effects of rapid weight gain in early life. J Clin Endocrinol Metab. 2012;97(12):4498-4506. Disclosure of Interests None declared
AB0017 T HELPER /REGULATORY T CELLS RATIOS IMBALANCE IN DIFFERENT STAGING RHEUMATOID ARTHRITIS
Authors: R. Su, C. Wang
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that results in the destruction of the bone and cartilage of the joints [1] .The imbalance between Th17 and Treg cells has been demonstrated to play a role in RA pathogenesis [2]. With the advances in the RA field, curing and even preventing RA has become a new direction of efforts. To explore the immune characteristics in multi-staging RA is helpful for the development of accurate strategies. Objectives To observe the immune characteristics in different staging rheumatoid arthritis patients Methods A total of 127 patients with RA were recruited for this study, in cluding 30 early RA(newly diagnosed and treatment-naive,duration of disease ≤3months), 30 midddle RA (newly diagnosed and treatment-naive, duration of disease &gt;3months and≤1 year), 30 advanced RA(newly diagnosed and treatment-naive,duration of disease &gt;1 year) and 37 active treated RA (remissioned after target treatment and this time due to disease recurrence in hospital). All patients were hospitalized in the second hospital of Shanxi medical university and diagnosed with RA fulfilled the ACR 1987 or 2010 criteria.The percentage and absolute numbers of lymphocyte phenotypes and CD4+ T subsets in peripheral blood were examined by flow cytometry. Results There were no significant difference in the percentage and value of T,B,NK,CD4+T,CD8+T andCD4+T subsets. But the Th1/Th2 cell ratios in active treated RA group were increased than that in early RA, middle RA and advanced RA group.The Th17/Treg cell ratios in middle RA and advanced RA group were higher when compared with those of active treated RA group.In addition, the Th1/ Treg cell ratios were decreased in middle and advanced RA group as compared with those in active treated RA. Conclusion Th1/Th2,Th17/Treg and Th1/Treg imbalance varied with disease staging.The different disease staging in RA, the immune function is different. Providing targeted immunotherapy according to disease staging is helpful to improve remission rates and even prevent disease. References [1]Petrovská N, Prajzlerová K, Vencovský J, Šenolt L, Filková M.The pre-clinical phase of rheumatoid arthritis: From risk factors to prevention of arthritis.Autoimmun Rev.2021, 20(5):102797. [2]Alison M Gizinski, David A Fox.T cell subsets and their role in the pathogenesis of rheumatic disease.Curr Opin Rheumatol,2014;26(2):204-10. Figure 1. The comparsion about the lymphocyte subsets and cell ratios in peripheral blood of different stage RA patients.(*p&lt;0.05) Disclosure of Interests None declared
AB0469 EVALUATION OF SALIVARY GLAND ALTERATIONS IN SJÖGREN’S SYNDROME WITH MULTISPECTRAL OPTOACOUSTIC TOMOGRAPHY
Authors: B. Hofauer, F. Johnson, Z. Zhu
Journal: Annals of the Rheumatic Diseases (2022)

Background More than half of all patients with Sjögren’s syndrome (SjS) show characteristic sonomorphological changes in the salivary glands. The relevance of this alterations for diagnosis and follow-up has been investigated in multiple studies. However, it is still not known which parenchymal changes cause this sonomorphological picture. Multispectral optoacoustic tomography (MSOT) is based on the photoacoustic effect – by exciting different chromophores with lasers of different wavelengths, information on tissue composition can be generated. With the help of MSOT, knowledge about tissue changes in salivary glands in patients with SjS should be gained for the first time. Objectives Can MSOT be applied in the area of the salivary glands and provide new information on the parenchymal changes in SjS? Methods In patients with SjS, classified according to the ACR/EULAR classification criteria, the ESSPRI and ESSDAI were recorded and tear flow and unstimulated salivary flow were determined. The sonomorphological changes in the salivary glands were evaluated using the OMERACT scoring system. Using MSOT, collagen, lipids and (de)oxygenated hemoglobin of the parotid and submandibular glands on both sides were measured (MSOT Acuity Echo). Results Twenty-three patients were included in the study (21 women, age: 62 years). At the time of the study, the ESSPRI averaged 47 points and the ESSDAI 8.5 points. The Schirmer test gave an average value of 6.4 mm/5 min, the unstimulated salivary flow (UWSF) 0.2 ml/5 min. The evaluation of the B-mode sonography showed predominantly hypoechoic lesions and less hyperechoic bands. In the evaluation of the tissue information obtained by means of MSOT, a correlation between increased lipid content and salivary flow measurement was shown as well as a significant difference between collagen proportion between parotid and submandibular glands. Conclusion With the help of MSOT, statements about the actual tissue changes within the salivary glands in SjS can be made for the first time. This project demonstrated for the first time a correlation between tissue composition and clinical parameter. The evaluation of other wavelengths in order to obtain further information on the tissue composition is planned. Disclosure of Interests None declared
AB0204 DOES THE PRESENCE OF COXITIS IN RHEUMATOID ARTHRITIS CHANGE THE DISEASE SEVERITY PROFILE?
Authors: A. Ben Tekaya, E. Hannech, O. Saidane, S. Bouden, R. Leila, R. Tekaya, I. Mahmoud, L. Abdelmoula
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by intra-articular manifestations affecting small and large joints. Hip involvement is not common but it can predict a severe disease course [1]. Objectives Our study aimed to investigate the prevalence of coxitis in RA patients and to compare patients with RA coxitis (+) and RA coxitis (-) according to their clinical, biological outcomes and their therapeutic findings. Methods This was a retrospective and comparative study, which include patients diagnosed with RA according to the ACR/EULAR 2010. Sociodemographic, clinical, biological, and therapeutic data were collected. The diagnosis of coxitis was made on plain x-rays or MRI. Results Among 255 RA, there were 30 RA coxitis (+) (11.8%). Coxitis was unilateral in 28 patients and bilateral in 2 patients. The mean delay onset of coxitis was about 11.6 ± 8.4 years (1-27). The mean age was 57.5 ± 12.2 years for RA coxitis (+) and 59.1 ± 10.5 years for RA coxitis (-) (p=0.5). The gender distribution was (70% female and 30% male) for RA coxitis (+) and (85% female and 15% male) for RA coxitis (–) (p= 0.04). The mean Body Mass Index was 24.8 ± 4.8kg/m 2 in RA coxitis (+) and 28 ± 5.8 kg/m 2 in RA coxitis (-) (p= 0.03). Comorbidities were present in 46% of RA coxitis (+) and 48% of RA coxitis (–) (p=0.8). Extra articular manifestations were noted in 76% RA coxitis (+) and 66% RA coxitis (–) (p=0.8). RA was seropositive in 76% RA coxitis (+) and in 82% RA coxitis (–) (p=0.4). RA was immunopositive in 51% RA coxitis (+) and 69% RA coxitis (–) (p=0.04). The mean DAS28 (CRP) was respectively 4.6± 1.1 in RA coxitis (+) vs 4.8 ± 1.1 RA coxitis (-) (p=0.7). Atlanto-axial dislocation was noted in 60% RA coxitis (+) and 22% RA coxitis (–) (p&lt;10 -3 ). The use of corticosteroid was noted in 92% RA coxitis (+) and in 90% RA coxitis (–) (p=0.7). Biologic drugs were prescribed in 43% RA coxitis (+) and in 25% RA coxitis (–) (p=0.04). Conclusion Our study showed that coxitis in RA patients is associated with a higher risk of Atlanto-axial dislocation and a more frequent use of biologic drugs reflecting a more severe and mutilating disease. We highlight the importance of an early diagnosis and treatment to prevent complications. References [1]Bajraktari IH, Krasniqi B, Rexhepi S, Bexheti S, Bahtiri E, Bajraktari H, Luri B. Prevalence of Coxitis and its Correlation with Inflammatory Activity in Rheumatoid Arthritis. Open Access Maced J Med Sci. 2018;6(2):336-339. Disclosure of Interests None declared
POS1105 EFFICACY AND SAFETY OF COLCHICINE FOR THE TREATMENT OF OSTEOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF INTERVENTION TRIALS
Authors: A. Singh, P. Molina-Garcia, S. Hussain, A. Paul, S. K. Das, Y. Y. Leung, J. Samuels, B. Antony
Journal: Annals of the Rheumatic Diseases (2022)

Background Colchicine, an approved treatment for gout, has been trialled in many diseases, including osteoarthritis (OA), due to its anti-inflammatory effects. However, its efficacy and safety remain unclear in OA. Objectives This systematic review and meta-analysis evaluated the efficacy and safety of colchicine for the treatment of OA. 1 Methods PubMed, Web of Science, Scopus, and Cochrane Central were searched from inception through November 2020. Two reviewers independently screened for randomised controlled trials (RCTs) comparing colchicine with placebo or other active-comparators for the treatment of OA (knee, hand, or hip OA), extracted data, and performed Cochrane risk of bias assessments. Results The search retrieved 391 articles after removing duplicates, and 16 full-text articles were reviewed for eligibility (Figure 1 A ). Ten RCTs, nine in knee OA, one in hand OA, consisting of 847 patients (429 in colchicine arm, 409 in control arm) were included. RCTs were conducted between 2002 and 2021; three in India, two in Iran and Turkey, and one each in Australia, Singapore, and Iraq; follow-up period ranged 2 to 12 months. Moderate-quality evidence showed no clinically important pain reduction with colchicine compared to placebo in knee/hand OA patients (standardised mean difference [SMD], -0.17; 95% confidence interval [CI], -0.55 to 0.22) (Figure 1 B ). Moderate-quality evidence showed no improvement in dysfunction with colchicine compared to placebo in knee OA patients (SMD, -0.37; 95% CI, -0.87 to 0.13). Colchicine showed an acceptable safety profile with AEs/SAEs comparable to placebo (Figure 1 C ) Conclusion Current evidence does not conclusively suggest a benefit of colchicine in reducing pain and improving physical function in hand/knee OA patients. Future trials should focus on the sub-groups of OA patients with local or systemic evidence of inflammation and/or mineralisation who may benefit from colchicine. References [1]Rheumatology (Oxford). 2018 Jan 1;57(suppl_1):i4-i11. Disclosure of Interests None declared
POS1397 USEFULNESS OF <sup>18</sup>F-FDG PET/CT FOR POLYMYALGIA RHEUMATICA DIAGNOSIS
Authors: C. Casadepax-Soulet, B. Crestani, K. Benali, M. Forien, E. Ebstein, P. A. Juge, P. Dieudé, S. Ottaviani
Journal: Annals of the Rheumatic Diseases (2022)

Background Polymyalgia rheumatica (PMR) is an inflammatory disorder affecting elderly people. The diagnosis is based on clinical and imaging findings such as ultrasonography. The interest of 18 F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography ( 18 F-FDG PET/CT) in PMR is increasing. However, its exact place in the diagnosis or management of PMR patients remains unclear. Objectives We aimed to describe the utility 18 F-FDG PET/CT for PMR diagnosis. Methods We performed an observational retrospective study of patients with new onset of PMR having a 18 F-FDG PET/CT. Diagnosis of PMR was done according to ACR/EULAR 2012 classification criteria. A control group, including patients with sarcoidosis, neoplasia or infection, was also analyzed. The following sites were assessed for the presence of hypermetabolism (SUVmax ≥ 2): shoulders, acromioclavicular and sternoclaviculaire joints, hips, symphysis pubis, ischial tuberosities, great trochanters, cervical and lumbar interspinous process and large vessels. The number of hypermetabolic sites (0-18), the median SUVmax and the highest SUVmax were analyzed. Results A total of 85 PMR patients (60% of female, mean age 70.7 years) and 75 controls (51% of female, mean age 65 years) were analyzed. Among PMR patients, hypermetabolism was mostly observed in shoulders (93%), hips (91%), great trochanters (87%), ischial tuberosities (89%) and lumber interspinous process (71%). Large vessel vasculitis was only observed in 7% of PMR patients. In comparison to control patients, PMR had higher number of hypermetabolic sites (11.3 ±3.3 vs. 0.85 ±1.1, p&lt;0.001), and mean SUVmax score (3.9 ±0.8 vs. 2.7 ±0.4, p&lt;0.001). After adjustment to age, the number of hypermetabolic sites (OR 2.57 [1.84; 4.51], p&lt;0.001) and the mean SUVmax were associated with the diagnosis of PMR (OR 1.49 [1.30; 1.78], p&lt;0.001). Among PMR patients, the C-reactive protein (CRP) levels were correlated with the mean SUVmax (r=0.38, p&lt;0.001), the number of hypermetabolic sites (r=0.34, p&lt;0.01) and the highest SUVmax (r=0.38, p&lt;0.001). Conclusion 18 F-FDG PET/CT appears to be a sensitive imaging for PMR. The number of hypermetabolic sites and the man SUVmax are correlated with CRP levels and PMR diagnosis. Disclosure of Interests None declared
AB0285 MTX REDUCED THE CARDIOVASCULAR RISK IN RHEUMATIC DISEASES
Authors: H. Ferjani, M. Abbes, H. Riahi, E. Labbene, W. Triki, D. Ben Nessib, K. Maatallah, D. Kaffel, M. Bouaziz, W. Hamdi
Journal: Annals of the Rheumatic Diseases (2022)

Background The relationship between cardiovascular risk (CVR) and inflammatory rheumatic diseases (IRD) remains certain [1]. The aggressive suppression of systemic inflammation by the CsDMARDs or biologics may lower this risk. Objectives The purpose of this study was to assess the protective role of the different treatments in rheumatoid arthritis (RA) and spondyloarthritis (SpA). Methods We carried out 107 patients followed up for IRD between March and December 2020. We collected the socio-demographic data of patients, the clinical and biological characteristics of the disease. Prescribed treatments were specified. CVR was assessed by measuring, in centimeters, the Intima-media Thickness (IMT) at the level of the left (LCC) and right (RCC) common carotid arteries and by calculating the Framingham risk score (FRS) for each patient. Individuals with IMT≥0.9 mm or an FRS≥20% were considered as those with high CVR (HCVR). Results Of the 107 surveyed patients, 56% had RA (n=47) and 44% had SpA (n=60). Among them, 55% were male. The mean age was 43.9±14.2 years. The mean disease duration was 117.3±89 months. The mean BASDAI was 4.98 ±2.7. The mean DAS28 was 4.13±1.5. Seventy percent of patients had active disease. Conventional DMARDs were prescribed in 54.7% of cases: Methotrexate (95% in RA versus 5% in SpA) and Sulfasalazine (13% in RA versus 30% in SpA), NSAIDs in 57.3% of patients (4.5% in RA versus 96.6% in SpA), corticosteroids (CT) in 25% (47.5% in RA versus 8.5% in SpA), and biotherapy in 9% of cases (12.8% in RA versus 6.7% in SpA). The mean FRS was 5.98 ± 6.6. The mean IMT was 0.58±0.15. About 60% of patients were considered with HCVR. NSAIDs were associated with an increase in IMT in the LCC (p&lt;0.001) and in the RCC (p&lt;0.001). MTX had a significant protective effect on IMT in LCC (p=0.001). However, there was no association between CT use and IMT. Regarding FCS, no significant association was found based on MTX (p=0.09), NSAIDs (p=0.11), CT (p=0.45) nor biologic use (p= 0.74). Conclusion In our study, patients taking MTX had a lower IMT than those not taking this molecule. NSAIDs were associated with an increase in IMT. However, we didn’t observe any effect of CT and biologic treatment on CVR in our population. References [1]Cho SK, Kim D, Won S, Lee J, Park B, Jang EJ, Bae SC, Sung YK. Impact of anti-rheumatic treatment on cardiovascular risk in Asian patients with rheumatoid arthritis. Semin Arthritis Rheum. 2018;47(4):501-506. Disclosure of Interests None declared
POS0408 TRANSFER OF HUMAN RHEUMATOID ARTHRITIS MONONUCLEAR CELLS INDUCES ARTHRITIS IN IMMUNODEFICIENT HLA-DR4 TRANSGENIC MICE
Authors: J. Rupp, J. Fessler, S. Hayer, B. Dreo, A. Lackner, P. Fasching, W. Helberg, P. Schlenke, J. Thiel, G. Steiner, W. Cornelia, M. Stradner
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatoid arthritis (RA) is a systemic autoimmune disease leading to erosive joint destruction. Although the exact pathogenesis is still elusive, the strong association of certain HLA class II molecules, such as HLA-DRB1*0401 (HLA-DR4), suggest involvement of CD4 + T cells (1,2). Mouse models of RA mimic specific aspects of the disease but are limited by the differences between human and murine immune systems. Objectives We aimed to establish a humanized mouse model (humice) carrying DR4 + RA PBMCs to study its role in the pathogenesis of RA without putting patients at risk. Methods Peripheral blood mononuclear cells (PBMC) of HLA-DR4 positive RA patients or controls were isolated and injected into NSG-Ab 0 DR4 mice (NOD-scid IL2Rgamma null mice lacking MHC class II while expressing the human HLA-DR4) to create humice. Human immune cell composition within humice was profiled using flow cytometry. Development of RA was monitored by examination of the joints and micro computed tomography analysis. Joints were analysed by histology regarding pannus formation, bone erosions, cartilage damage, and human cell infiltration. Results Transfer of RA PBMCs induced arthritis in humice recapitulating hallmarks of RA including immune cell infiltration, pannus formation, increased osteoclastogenesis, cartilage damage, and bone erosions. Arthritis was dependent on the implanted human cells as NSG-Ab0 DR4 mice without transfer of human PBMCs did not develop arthritis. T-helper 1 (Th1) cells, dominated the human immune cell composition in humice, while regulatory T cells (Tregs) were diminished compared to donor PBMC composition. Mice humanized with cells from RA patients were more likely to develop inflammatory joint disease, compared to healthy HLA-DR4 positive controls (RA donor 70% vs. healthy control 20%, p=0.00196). CTLA-4 Ig treatment prevented arthritis development in this model (p=0.0055). Conclusion Humice carrying DR4 + RA PBMCs developed an RA-like erosive joint disease driven by the implanted human immune system. The data implies that the disease can be transferred by arthritogenic cells found in the peripheral blood of RA patients. This model will allow new insights into the pathogenesis of RA. References [1]Goulielmos GN, Zervou MI, Myrthianou E, Burska A, Niewold TB, Ponchel F. Genetic data: The new challenge of personalized medicine, insights for rheumatoid arthritis patients. Gene Available from: http://www.ncbi.nlm.nih.gov/pubmed/26869316 [2]Holoshitz J. The rheumatoid arthritis HLA–DRB1 shared epitope. Curr Opin Rheumatol Available from: http://www.ncbi.nlm.nih.gov/pubmed/20061955 Disclosure of Interests None declared.
AB0171 TOWARDS A BETTER IMPLEMENTATION OF TREAT-TO-TARGET STRATEGY IN RHEUMATOID ARTHRITIS: A COMPARISON OF TWO REAL-WORLD COHORTS
Authors: H. Huang, W. Xie, Y. Geng, Y. Fan, Y. Wang, J. Zhao, Z. Zhang
Journal: Annals of the Rheumatic Diseases (2022)

Background Treat-to-target (T2T) strategy has been the core of rheumatoid arthritis (RA) management for over a decade, however implemented distinctly varied in real practices. Objectives We tried to investigate the differences in disease activity and target achievement of two cohorts with different T2T implementations. Methods We used data of the CENTRA (Collaboratively intENsive Treat-to-target in RA) and TARRA (Treat-to-TARget in RA) cohorts. The CENTRA is a RA cohort prospectively follow-up by a fixed team with tight control, while the TARRA is a longitudinal observational cohort follow-up by a rheumatologist with casual control. Patients from two cohorts were matched 1:3 by propensity score matching (PSM). The primary outcome was simplified disease activity index (SDAI) at 1-year follow-up. Results 102 patients from the CENTRA cohort and 271 patients from the TARRA cohort were included. Both groups were comparable in terms of age, gender, disease course, and seropositivity. At the end of 1 year follow-up, the SDAI of patients in the CENTRA cohort was significantly lower than that of patients in the TARRA cohort (2.1 vs 3.4, p＜0.001). The follow-up interval of patients in the CENTRA cohort was significantly shorter than that in the TARRA cohort when patients have not achieved remission (3.1 vs. 3.3 months, p=0.019). Conclusion RA patients may benefit more from a tight control T2T strategy with closer follow-up and appropriate education compared with a casual T2T strategy. Disclosure of Interests None declared